‘Exposed, silenced, attacked: failures to protect health and essential workers during the COVID-19 pandemic’

This timely and shocking report compiled by ‘Amnesty International’ opens with the stark figure of 3000 health workers losing their lives due to the global COVID-19 pandemic up to the time of writing, with a warning that this figure:
“ . . . is likely to be a major underestimate given a lack of reporting . . . many others have worked in unsafe environments due to shortages in personal protective equipment (PPE). They have further faced reprisals from the authorities and their employers for raising safety concerns, including arrests and dismissals, and even in some cases been subjected to violence and stigma from members of the public”.

https://www.amnesty.org/download/Documents/POL4025722020ENGLISH.PDF

While in many countries there is no systematic tracking of how many health and essential workers have contracted COVID-19 and died as a result, the International Council of Nurses estimates that more than 230,000 health care workers have contracted the disease, and more than 600 nurses died. According to a survey published in May 2020 by Public Services International, in 62 countries, less than a quarter of trade unions reported having adequate equipment. Workers who have spoken out have in some countries faced dismissal and arrest or been threatened with reprisals. In addition, there have been health and essential workers who have faced stigma and violence. The report looks at concerns around occupational health and safety, retaliation, and problems of violence and stigma directed at health and other essential workers. It also flags some broader structural issues in health and social support systems across the world that have exacerbated these issues and require urgent attention.
What does the report tell us about the situation in the UK?

Increased risk of death compared with the general working population has been shown for male and female nurses, male nursing auxiliaries and assistants, male and female social care workers and male health care workers. Other occupations with raised death rates for men included taxi drivers and chauffeurs, bus and coach drivers, workers in factories, and security guards. As of 26 June 2020, 268 deaths involving COVID-19 had been registered among social care workers, and 272 deaths amongst health workers, in England and Wales. It is now well established that BAME health workers (that is, health workers who identify as black, Asian, or minority ethnic), are significantly over-represented in the total number of COVID-19 related deaths, with up to 60% of health workers who died coming from BAME communities.

The British Medical Association carried out a survey with over 16,000 doctors in the UK on the question of adequate PPE in April 2020. Around 48% of respondents reported buying PPE for their own use or that of their department, or using donated PPE, due to lack of supplies where they worked. Overall, 65% of doctors said they felt either “partly or not at all protected”. The UK is one of at least eight countries in which health workers have appealed for help through the courts by launching legal challenges over inadequate supplies.

Workload and mental health concerns
Amnesty has collected moving testimony from health care workers, giving a vivid insight into stresses at work. This is a quote from a nurse in the UK:
“In terms of what it’s like at the moment, every day is like running on a treadmill with the speed set on high and you trying to keep your pace, everyone is tired and anxious. As ITU nurses we’ve gone from having one patient to having 3-5. We’ve got amazing colleagues from other parts of the hospital coming to help us, but they’re anxious being in this environment and need a lot of support and guidance that we can’t give. It’s emotionally exhausting; I’ve heard a son say goodbye to his mother over the phone, admitted a nurse from one of the wards and held her hand as she was put to sleep to be put on the ventilator and comforted a woman who lost her husband at the age of 40 leaving her to bring up two kids alone. I’ve cried a lot.”
Increased workloads and increased anxiety and stress are likely to exact a heavy toll on health and care workers, with depression, anxiety and insomnia now being commonly reported in Chinese staff. Failure to recompense workers for extra hours and workload adds further pressure. Porters, cleaners and social care staff were initially left out of a scheme under which families of health workers who died of COVID-19 were granted indefinite leave to remain in the UK although a campaign was successful in getting this amended to include them. For many workers who are outsourced there is the additional worry of not being paid for sick leave, or periods of self isolation crucial to controlling the spread of disease.
Workers have rights that must be respected
According to UN Special Rapporteur:
“No worker is expendable. Every worker is essential, no matter what category is applied to them by States or businesses. Every worker has the right to be protected from exposure to hazards in the workplace, including the coronavirus . . . Our message today is simple, but crucial: every worker must be protected, no matter what”.
This damning report by Amnesty makes for grim reading but provides a voice for hard pressed health and care workers across the world, working under very different conditions but united by a common enemy and fighting against common problems. Governments must listen to the many recommendations set out, including the following:

“States should ensure that employers provide all health and essential workers with adequate PPE to protect themselves during the COVID-19 pandemic, in line with international standards.
States should recognise COVID-19 as an occupational disease, and workers who contract COVID-19 as a result of work-related activities should be entitled to cash compensation and medical and other necessary care.
Health and essential workers’ safety concerns must be listened to and addressed in an appropriate manner. There must be no retaliation against workers for raising concerns or lodging a complaint related to health and safety.
Comprehensive, effective and independent reviews should be carried out regarding states’ and other actors’ preparedness for and responses to the pandemic. Where there is cause to believe that government agencies did not adequately protect human rights – including the rights of health and essential workers – in the context of the pandemic, states should provide effective and accessible remedies, including through thorough, credible, transparent, independent and impartial investigations into these allegations.
States should collect and publish data by occupation, including categories of health and other essential workers who have been infected by COVID-19, and how many have died as a result, in order to ensure effective protection in the future.”
While busy rewriting history, blaming others for a disastrous response to the pandemic including ongoing serious failures, our government must heed these calls as well as being held to account. The pandemic is by no means over, and “no worker is expendable”.

COVID-19: children on the front line : Dr John Puntis

No doubt Munro and Faust intended to be provocative,1 but there is an unfortunate non-sequitur
in the title of their Viewpoint paper: based on limited evidence, the authors suggest that since children may not be super-spreaders for COVID-19, it is safe to reopen schools. While acknowledging a lack of high-quality sero-surveillance data, the paper then reiterates: “Governments worldwide should allow all children back to school”. If only it were that simple. In fact, the question should not be ‘are children
super-spreaders?’

But ‘what effect will re-opening schools to all pupils have on the local community in terms of spread of
coronavirus?’

Schools vary with regard to feasibility of social distancing (still considered essential), and risk factors for severity of illness among staff and pupils, and simply do not operate in a social vacuum. What happens in schools will have ramifications for everyone within and outside of schools. When the reproduction rate for the virus is above 1 in the North East of England, does it really make sense to open up the schools? The Independent SAGE (ISAGE) group report2 recommended that: “decisions on school opening be made at local level, involving all stakeholders, to ensure there is support available as schools progress
to full function”.

The UK government’s own criteria for easing lock-down included a requirement for measures to be in place to avoid a second wave of infection, contingent on an effective ‘test and track’ system.3 This was reiterated by the Children’s Commissioner, who called for a “phased return to school, accompanied by rigorous COVID-19 testing of teachers, children and families to ease safety fears among parents”.4
Government was fixated on schools opening their doors on 1 June without considering just how this could be facilitated, and at a time when new cases of infection and deaths occurring daily were estimated to be around 17 000 and 300, respectively. Testing even for those with classic symptoms of COVID-19 infection has proved problematic, while contact tracing systems at the start of June were
just being launched and may not be fully working until the end of September (if by then).

Lack of trust in government stemming from refusal to acknowledge mistakes and inconsistencies in advice regarding rules for social isolation have led many parents to keep their children out of schools, with only one in four of those eligible returning. I concur with ISAGE2 that decisions on school opening must be guided by evidence of low levels of COVID-19 infections in the community and the ability to rapidly respond to new infections through a local test, track and isolate strategy. Meanwhile, a plan is needed for education as for business.

This should include computers for disadvantaged children, on-line teaching, use of temporary accommodation such as sports halls so that social distancing can be maintained, and summer clubs to help make up for missed social opportunities. Transparency and honesty from those in power will also be needed to rebuild faith in official advice. Child super-spreading hardly comes into it.
John WL Puntis
Leeds, UK
Twitter John WL Puntis @John Puntis
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. To cite Puntis JWL. Arch Dis Child Epub ahead of print: [please include Day Month Year]. doi:10.1136/archdischild-2020-319911

REFERENCES
1 Munro APS, Faust SN, Munro APS. Children are not COVID-19 super spreaders: time to go back to school. Arch Dis Child 2020;105:618
2 Independent SAGE Report 2. Should schools reopen? Interim findings and concerns. Available: http://www.independentsage. org/ wp- content/ uploads/ 2020/05/ Independent- Sage- Brief- Report- on- Schools. pdf[Accessed Jun 2020].
3 Quinn B. Have the government’s five tests for easing lockdown been met? Guardian, 2020. Available: https://www. theguardian. com/ politics/ 2020/ may/ 06/ have- thegovernments-five- tests- for- easing- lockdown- been- met[Accessed Jun 2020].
4 Giordano C. Government and teaching unions told to’stop squabbling’ about re-opening schools. Available: https://www. independent. co. uk/ news/ uk/ politics/coronavirus- uk- schools- reopen- teachers- gavinwilliamson-naht- nasuwt- a9517886. html [Accessed Jun2020].

To control coronavirus, we need public health back in public hands – Dr John Puntis

The Westminster government has set out its plan for dealing with Covid-19. This makes plain there is no prospect of return to normality until vaccines and effective anti-viral treatments become available:

“It is clear that the only feasible long-term solution lies with a vaccine or drug-based treatment”

while at the same time acknowledging these may never materialise:

 “A mass vaccine or treatment may be more than a year away. Indeed, in a worst-case scenario, we may never find a vaccine . . . .  as vaccines and treatment become available, we will move to another new phase, where we will learn to live with COVID-19 for the longer term without it dominating our lives”.

The government focus is therefore only to control the epidemic and to:

“ . . . enact measures that have the largest effect on controlling the epidemic but the lowest health, economic and social cost . . rolling out effective treatments and/or a vaccine will allow us to move to a phase where the effect of the virus can be reduced to manageable levels.

begging the question –  what does this look like in practice?

The answer is that we will have to live with a background level of new infections and deaths; surges in cases and reintroduction of lockdowns; public transport, schools, pubs and restaurants all operating at limited capacity; a huge rise in unemployment; considerable disruption to all areas of life.

Rather than seeing mass testing and contact tracing together with current non-pharmacological interventions as a potential Public Health solution to our problems, it is presented as something that offers only a limited prospect of success, such that it:

“may allow us to relax some social restrictions faster by targeting more precisely the suppression of transmission”

Illustrating how seriously government take the issue of ‘Test & Trace’, Johnson used the colourful analogy of the arcade game ‘Whac-A-Mole’, where plastic moles pop up at random from each of five holes and the player forces them back down by hitting them directly on the head with a mallet. The score, however, is likely to be low, since the most recent data on ‘Test & Trace’ showed that only 25% of contacts of new cases were being reached. The official SAGE committee says that 80% of the contacts of all symptomatic cases must be found and isolated in order to stop the virus spreading further.

The government lists the following as essential to any effective infection control system:

• widespread swab testing with rapid turn-around time, digitally-enabled to order the test and securely receive the result
• local authority public health services to bring a valuable local dimension to testing, contact tracing and support to people who need to self-isolate
• automated, app-based contact-tracing through the new NHS COVID-19 app to (anonymously) alert users when they have been in close contact with someone identified as having been infected
• online and phone-based contact tracing, staffed by health professionals and call handlers

As of mid-June, none of these requirements have been fully met and some seem but distant promises. There has been a major problem with testing and retrieval of results, as well as government misinformation exaggerating the extent of testing earning a rebuke from the Royal Statistical Society. Local authority public health services have been marginalised despite their expertise in contact tracing through communicable diseases and environmental health teams. £300 million was made available to support new test and trace services locally, but this amounted to an average of only around £870k for each council. There is a financial disincentive for many contacts to self isolate, recognised as a huge barrier to the effectiveness of contact tracing even by conservative MPs.

Hancock’s Half App

Mobile phone apps are part of the modern epidemiologist’s armamentarium for fighting infectious disease. South Korea has had one of the lowest case mortality rates in the world and together with widespread testing also employed mobile phone technology to track peoples movements. Early on in lockdown, Health Secretary Matt Hancock heavily promoted a home grown mobile phone app, saying it would be crucial in getting “our liberty back” and suggesting the public had a “duty” to download once available. The app, installed on a smart phone, would be designed to automatically track when users come into contact with each other, using Bluetooth technology. If someone using the app disclosed that they had developed COVID-19 symptoms, this would trigger an anonymous alert to anyone they had recently been in contact with, providing they were also using the app. This would prompt testing and self isolation, and if enough people were to use it (>60% of the population) and follow public health advice, it was expected to bring about a reduction in infections.

The security of the app was quickly challenged, and journalists reported development was being dogged by problems including a data-hungry approach, an attempt to defy Apple and Google, intra-agency bickering and a problematic test run on the Isle of Wight. The app used a centralised model, meaning that the data was not just kept on an individual’s phone, but collected centrally by government, unlike most other European countries – such as Germany, Italy and Ireland – where a more privacy-protecting decentralised model was chosen. The UK approach was heavily criticised by Amnesty International among other organisations, and lack of trust seemed likely to reduce its appeal among the public.

The deadline for being rolled out in mid-May passed quietly, and in June, the app was downgraded to only ‘the cherry on the cake’ and no longer a key part of the contact tracing strategy. On 18^th June, after millions of pounds spent on technology that experts had repeatedly warned would not work, it was made clear that the project had finally been abandoned.

Track & Trace

In May, the person appointed to be in charge of the new ‘Track & Trace ‘ system was announced as Dido Harding. A businesswoman, who in 2017 had been drafted into NHS Improvement despite having no credentials in healthcare, she was misleadingly described by the prime minister as a “senior NHS executive”. Harding was severely criticised when, as chief executive officer of mobile phone company TalkTalk, there was a major data breach involving the personal and banking details of around 4 million customers. She has been described as one of the elite club of chief executives who consistently manages to fail upwards. Her other roles include being a director of the Jockey Club which runs the Cheltenham racecourse and attracted 250,000 people to the Cheltenham Festival only days before the long overdue lockdown was imposed. Her attitude to the NHS might possibly be judged by the fact she is married to John Penrose, a Conservative MP who sits on the advisory board of the think tank “1828”. According to The Mirror newspaper, 1828 argues for the NHS to be replaced by an insurance system and for Public Health England to be scrapped.

Meanwhile, the lucrative contract for contact tracing was given to Serco, a company that had just been fined £1m for failures on another government contract. In no time at all Serco had its own data breach, inadvertently revealing the email addresses of new recruits. The junior health minister, Edward Argar, happens to be a former Serco lobbyist and the company’s chief executive is Rupert Soames, grandson of Winston Churchill. Like Marley’s ghost in ‘Christmas Carol’, Serco is forever condemned to drag around a heavy weight of previous misdemeanours, including being fined £19m in 2010 over deficiencies in electronic tagging. Even optimistic NHS officials don’t expect the scheme to be fully operational until September or October, and a leaked email from Soames revealed that among other concerns, he hoped the contract would cement the position of the private sector in the NHS supply chain.

Early data on Serco’s record with ‘Test & Trace’ indicated that only a woefully inadequate 25% of contacts were identified compared with the 80% that is needed. A poll also showed that involvement of the private sector in contact tracing undermined public confidence, with 40% of those surveyed saying this made them less likely to hand over private data. An additional problem is how undocumented migrants can be brought into the system when they are worried about bills they cannot afford to pay and falling foul of the Home Office. Looking at both the disastrous app saga and the knee jerk outsourcing of contact tracing to Serco, it is difficult not to ask whether systems have in fact been designed to fail and ‘herd immunity’ somehow remains at the heart of government thinking.

An alternative view: Independent SAGE

In contrast to the Westminster government, the Independent SAGE group sees an effective COVID‐19 ‘Test & Trace’ programme as absolutely essential to the struggle to contain coronavirus infections. For good reasons, it prefers to talk of ‘Find, Test, Trace, Isolate and Support’ (FTTIS), since this encompasses all the essential features of the system. FTTIS is seen as indispensible for economic recovery, protecting livelihoods and securing longer‐term wellbeing and health provision. The key recommendations from its report are summarised below:

1. LOCAL: To be effective FTTIS must be led locally, coordinated by Directors of Public Health, using both the Local Authority and NHS including health commissioners, primary care, local hospital laboratories, school nurses and environmental health officers.
2. TRUST: The success of a FTTIS system is based on trust, requiring accountability mechanisms and effective community engagement.
3. DATA: FTTIS findings must be embedded within existing NHS, local authority and Public Health England data structures, with rapid access to enable local response. It is important to ensure governance and safeguards for privacy and data misuse, and any supporting apps must be implemented within such a framework.
4. ISOLATE and SUPPORT: This is critical if reduction in infection spread is to be realised. There must be facilities available for such isolation, material support including food and finance, and appropriate guarantees from employers, to ensure that those in isolation are not disadvantaged.
5. KEY PERFORMANCE INDICATORS (KPI): A set of key performance indicators should be reported weekly, including data that are timely, relevant, and useful to support local decision‐making.

Details of how all this might be achieved are covered in the report, which also argues that if current restrictions are to be relaxed:

“ . . we must try to find every new case, test them, trace their contacts, and then ask the new case and their contacts to isolate for 2 weeks to prevent further spread, with the support they need to continue with their lives in these new circumstances. We must go beyond a narrow response of simply testing people suspected of being infected and tracing their contacts, which is implied by the Westminster government’s use of the term “test and trace”.

“If COVID-19 is to be eliminated, as New Zealand has shown is possible, then at least 80% of all close contacts of someone with COVID-19 infection must remain isolated for 14 days so that they are unable to pass on infection to others . . . . We argue that the current government approach to what is called Test and Trace is severely constrained by lack of coordination, lack of trust, lack of evidence of utility, and centralisation, such that achieving the goal of isolating 80% of close contacts is impossible.”         

Learning from other countries

In Ireland, a group of over 1,000 scientists have launched a campaign to eradicate new cases of coronavirus, called “crush the curve”. This has drawn inspiration from countries such as South Korea, Iceland, Australia, Austria, New Zealand, Greece and China, and calls for a new strategy in Ireland aimed at complete suppression of the virus. It is argued that this is a realistic objective and can be achieved by continuing public health measures, including the use of masks, active fast contact tracing and testing, and sensible restrictions on travel. All of these must be enhanced and coordinated.

The goal would be to suppress the number of new cases to zero as soon as possible, and to keep them there. With political leadership, an agreed and scientifically sound strategy, and cooperation from the public they argue that this is potentially achievable. When this goal is reached, new infections have to be closely monitored for the foreseeable future through a robust, rapid, and vigilant FTTIS infrastructure. South Korea has managed to achieve this feat with a population similar to that of England. There are already some parts of the UK where good contact tracing has meant that infection has almost disappeared such as Ceredigion, Guernsey and the Isle of Man.

Conclusion

The Westminster government needs to set its sights higher than it currently does with ‘Track & Trace’, replacing it with a ‘Find, Test, Trace, Isolate and Support’ system that aims not just to make life manageable until an effective vaccine or anti-viral drug materialises, but to eradicate new cases of COVID-19 altogether. The Independent SAGE group points the way, and many scientists in Ireland are ready to grasp the nettle. This is why one of our key demands must be ‘bring back public health into public hands’.

Patient voices of the NHS in Leeds – Space2

#Reclaim the NHS #NHS72nd Birthday mini motorcade in South Leeds

 

#Spiritof2020 #ReclaimtheNHS Happy 72nd Birthday to the NHS

COVID-19: children on the front line : Dr John Puntis

Charging those with uncertain immigration status for NHS services was introduced as part of Theresa May’s ‘hostile environment’. Non-payment of bills can result in being reported to the Home Office and used as a reason for not being granted settled status. This system remains in place during the COVID-19 pandemic, actively discouraging healthcare seeking through the threat of immigration enforcement.

Of around 618 000 people living in the UK but without the documentation to prove a regular immigration status, it is estimated that 144 000 are children,1 half having been born here. The legislation over charging introduced by the government under the spurious pretext of targeting ‘health tourism’ represented an unprecedented departure from the founding principles of the NHS and, among other adverse effects, has a negative impact on child health

Full article:
Children on front line artcle re migrant charges by John Puntis in ADC june 20

 

#NHS72 Birthday Weekend

Our NHS deserves better – full list of local and national events: https://keepournhspublic.com/our-nhs-deserves-better/

Leeds banners and window posters:

NHS 72nd Birthday events and NO to migrant charges

This weekend : Info and organisation re events to celebrate the NHS 72nd birthday next weekend 4th and 5th July (attached update)

Sat July 4th from 12 noon we are planning a small pop up event at LGI and St James with banners, music and some costumes. We would have loved to have invited lots of people and made this a big “Banners High” event but feel that we need to act more sensibly than Johnson and take great care not to give out the wrong signals or put anyone in harm’s way so we are aiming for 2 groups of 6 people. If you want to be involved, have your own transport or can share with someone in your household or bubble and are willing to hop from LGI to St. James or just cover one of the venues, please e mail leedskonp@yahoo.co.uk

On Sunday morning 5th July we are planning a motorcade starting in south Leeds. If you want to join in, assemble at 11am at Middleton Circus car park see map on attached doc. We will have posters, banners and some balloons but DIY car displays/ decorations very welcome.

If you are not going far from home at the moment, there is plenty you can do eg.

• Print off and display the attached A4 window poster and send to friends asking them to do likewise
• Join the 1 mins silence on Saturday evening at 8pm and the doorstep/ neighbourhood clap on Sunday 5th ( the actual NHS birthday ) at 5pm . ‘We Own It’ are encouraging people to bake cakes to share!
• Post on facebook the attached pic of the NHS 72nd birthday banner and share widely.
• Watch the national KONP/ Health Campaigns Together/ People’s Assembly/ We Own it rally 3.30-4.45pm on Sunday on facebook or youtube.

Other important updates

We heard feedback from Richard Horton ( editor of the Lancet )’s speech to Leeds Café Scientifique on Tuesday 23rd June . This is normally held at Seven Arts in Chapel Allerton. He gave a damning critique of the Government’s response to the pandemic. Look out for his book : The COVID-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again .

John has had a further exchange with Leeds Teaching Hospitals urging them to take a stand against migrant charges and the hostile environment.

Not only has the Govt’s app been abandoned but its track and trace system is only capturing one third to one half of people testing positive for Covid 19 and people are waiting 3 days and much longer to get test results.

John has written a piece challenging the Government strategy to live with the virus rather than supress it. If you are working in health and social care please consider signing this open letter to the Prime Minister calling for a change in strategy towards Covid-19 so that rather than living with it and all the disruption caused, we aim to eliminate, as in New Zealand. Background information in attached document. Please share with others working in health and social care.

NHS 72nd birthday window poster A4

Banner:

Yorkshire Health Campaigns Together Update and Migrant Surcharges letter for reuse

Yorks HCT meeting 29.5.20 (pdf)

Summary of actions:

• Circulate Leeds letter calling for both and end to NHS surcharges on workers from overseas and to charging migrants and others with undocumented status so groups can amend and use if they wish.
• Contact Gilda if you want to order one or more KONP rainbow banners : £25 for one including p&p but cheaper for larger quantities.
• John to write a letter to the Catholic Diocese and C of E education urging delay in opening schools with assistance from Nick.
• Local groups to start planning local action on or around Sat.4th July paying due attention to safety issues and share ideas: NHS birthday events and materials can be found at  https://mailchi.mp/keepournhspublic/april-newsletter-coronavirus-and-the-nhs-4076821

NB Please write to your MP to ask them to oppose the dangerous possibility of the NHS being on the table in the US trade deal negotiations. For info see We Own It’s website, especially the briefing from the trade justice group. https://weownit.org.uk/sites/default/files/downloadableresources/New%20briefing%20on%20NHS%20and%20Trade.pdf

You can also take a pic of yourself with this poster and post it widely.

Next meeting June 26th   4 – 5.30pm       ( Zoom info to be sent with a reminder closer to 26^th)

The letter re NHS surcharges and migrant charges which Leeds KONP sent to councillors, the CCG, Leeds Teaching Hospital Trust and some MPs in case you would like to adapt it for your own use:

Open letter to Leeds MPs,  councillors  and  hospitals  re  NHS Charges  1^st May 2020

At this critical time when it is vital that there is unfettered access for all to the NHS, we are writing to you to urge you to take action to remove from our NHS all barriers to health care faced by overseas workers, migrants and anyone with undocumented status living in the UK.

The pandemic has highlighted:

• That people born outside the UK account for almost a quarter of all staff working in hospitals and a fifth of all health and social care staff in the UK (1). Not only are our health and social care systems disproportionately reliant on overseas workers but staff from black and minority ethnic communities are dying from Covid-19 at a much higher rate than others and almost half of those staff who have died were born overseas (2).
• That there is an uncomfortable and unjust disjuncture between the selfless work of staff from overseas who pay the same taxes as we do and the fact that they have to pay hefty fees to use the same NHS many of them are working so hard to sustain! These fees are currently over £400 per year but the Govt. has been planning to raise them to £625 and this applies not just to the staff member but each member of their family. For example a health professional from abroad with a partner and two children will have to pay £2,500 a year. The Home office acknowledged that the fees raised only £300m a year between 2015 and 2018. They were part of hostile environment legislation designed to deter immigration to the UK. (3)
• That creating barriers to using the NHS for migrants and other undocumented residents in the UK is unsafe for all of us as well as generating fear and anxiety. Although treatment for Covid-19 is free, fear of charging down the line and of being reported to the Home Office by health authorities deters those people with uncertain status from using the NHS. Everyone must now feel confident to seek treatment as needed and to aid in tracing contacts of anyone identified as infected with the virus (4) a strategy the World Health Organisation is urging all countries to adopt (5). Ireland, Portugal and South Korea have already taken action to remove barriers. In the UK sixty cross party MPs have sent a letter to the Health Secretary calling for the immediate suspension of charging for migrants and all associated data sharing between the NHS and the Home office (6). It follows a similar demand to Government from medical groups including the British Medical Association and Doctors of the World UK.

We believe that now, more than ever, it is vital to end the hostile environment in the NHS and ensure unfettered access for everyone to free health care. We are one community!

We therefore call on our MPs to urge the Government:  

• to drop surcharges for health care on workers from overseas
• stop all migrant charges and publicise this widely to encourage people to use the NHS when needed

We call on our Local Hospitals to:

• Suspend the NHS charges and stop reporting patient details and debt to the Home Office
• Take down all “hostile environment“ notices from hospitals and clinics
• Convey to the public that your hospital intends to treat everyone, freely and regardless of immigration status, as part of the effort to contain COVID-19

We call on our local Council to give substance to the title “City of Sanctuary” by:

• Doing all in their power to support and encourage ending health charges to migrants and health surcharges on staff from overseas

We call on trade unions, political party branches/constituencies and community organisations

• To endorse and publicise this letter to your members and use your political influence to pursue these demands.

References

1. https://www.nuffieldtrust.org.uk/news-item/one-in-four-hospital-staff-born-outside-the-uk-new-nuffield-trust-analysis-reveals
2. https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article
3. https://www.theguardian.com/society/2020/may/03/calls-grow-scrap-nhs-surcharge-migrant-healthcare-workers-coronavirus
4. BMJ Covid-19: Contact tracing requires ending the hostile environment. https://www.bmj.com/content/368/bmj.m1320.full
5. BMJ editorial “Covid-19: why is the UK government ignoring WHO’s advice?” https://www.bmj.com/content/368/bmj.m1284
6. https://www.independent.co.uk/news/uk/home-news/coronavirus-undocumented-migrants-deaths-cases-nhs-matt-hancock-a9470581.html